ArticleLiver international : official journal of the International Association for the Study of the Liver2020
Prevalence of and risk factors for anaemia in patients with advanced chronic liver disease.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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42 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Iron Status and Risk of Heart Disease, Stroke, and Diabetes: A Mendelian Randomization Study in European Adults.Journal of the American Heart Association · 2024Pooled it
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- Zinc deficiency and sarcopenia define a metabolic frailty phenotype predicting hepatic encephalopathy and early mortality in cirrhosis.Metabolic brain disease · 2026Article
- [Construction of a predictive model for recompensation in patients with decompensated viral hepatitis-induced cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Frailty After Transarterial Chemoembolization for Hepatocellular Carcinoma: A Cross-Sectional Study of Incidence and Associated Factors.Journal of multidisciplinary healthcare · 2026Article
- Hematological abnormalities in clinically diagnosed non-alcoholic steatohepatitis: prevalence, clinical correlates, and fibrosis risk in a case-control study from Qatar.Frontiers in medicine · 2026Article
- Article
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- Predictive value of neutrophil-to-lymphocyte ratio and MELD score for short-term survival of patients with HBV-DeCi.Biomarkers in medicine · 2025Article
- Early prediction of acute-on-chronic liver failure development in patients with diverse chronic liver diseases.Scientific reports · 2024Article
- Evaluating the Association between Anemia and the Severity of Liver Disease in Children with Cirrhosis: A Cross-Sectional Study from 2015 to 2020.Pediatric gastroenterology, hepatology & nutrition · 2024Article
- Relationship between Circadian System Status, Child-Pugh Score, and Clinical Outcome in Cirrhotic Patients on Waiting Lists for Liver Transplantation.Journal of clinical medicine · 2024Article
- Exploring Haematological Complications in Cirrhosis of the Liver: A Comprehensive Review.Cureus · 2024Review
- Anaemia is independently associated with mortality in patients with hepatocellular carcinoma.ESMO open · 2024Article
- Zinc supplementation with polaprezinc was associated with improvements in albumin, prothrombin time activity, and hemoglobin in chronic liver disease.Journal of clinical biochemistry and nutrition · 2024Article
- Elevated neutrophil-to-hemoglobin ratio as an indicator of poor survival in hepatitis B virus-related decompensated cirrhosis.Biomarkers in medicine · 2024Article
- Prognostic value of ascites in patients with liver cirrhosis undergoing cardiac surgery.Journal of cardiothoracic surgery · 2023Article
- Liver Iron Loading in Alcohol-Associated Liver Disease.The American journal of pathology · 2023Review
- Spur cells in liver cirrhosis are predictive of acute-on-chronic liver failure and liver-related mortality regardless of severe anaemia.Internal and emergency medicine · 2023Article
- Characteristics, Risk Factors, and Outcome of New-onset Systolic Heart Failure After Liver Transplantation: A Single-center Cohort.Transplantation direct · 2023Article
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Authors and funding
11 authors at 1 institution in 1 country.
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Abstract
backgroundAnaemia is common in advanced chronic liver disease (ACLD) as a result of various risk factors. AIMS &
methodsWe evaluated the prevalence and severity of anaemia as well as the impact of anaemia on clinical outcomes in consecutive patients with ACLD and portal hypertension.
resultsAmong 494 patients, 324 (66%) patients had anaemia. Anaemic patients showed higher MELD (12 ± 4 vs 9 ± 3; P < .001), lower albumin (34 ± 6 vs 39 ± 5 g/dL; P < .001) and more often Child-Pugh B/C stage (56% vs 17%; P < .001). The prevalence of moderate-severe anaemia (haemoglobin <10 g/dL) increased with the degree of portal hypertension (HVPG: 6-9 mm Hg: 22% vs HVPG: 10-19 mm Hg: 24% vs HVPG ≥ 20 mm Hg: 36%; P = .031). The most common aetiologies of anaemia were gastrointestinal bleeding (25%) and iron deficiency (9%), while reason for anaemia remained unclear in 53% of cases. Male gender (odds ratio [OR]: 1.94 [95% CI: 1.09-3.47]; P = .025), MELD (OR: 1.20 [95% CI: 1.09-1.32]; P < .001), hepatic decompensation (OR: 4.40 [95% CI: 2.48-7.82]; P < .001) and HVPG (OR per mm Hg: 1.07 [95% CI: 1.02-1.13]; P = .004) were independent risk factors for anaemia. Anaemia was associated with hepatic decompensation (1 year: 25.1% vs 8.1%; 5 years: 60.3% vs 32.9%; P < .0001), hospitalization (73% vs 57%; P < .001) and a higher incidence rate of acute-on-chronic liver failure (0.05 [95% CI: 0.04-0.07] vs 0.03 [95% CI: 0.01-0.04]). Anaemic patients had worse overall survival (1 year: 87.1% vs 93.7%, 5 year survival: 50.5% vs 68.6%; P < .0001) and increased liver-related mortality (1 year mortality: 9.7% vs 5.7%, 5 year mortality: 38.0% vs 26.9%; P = .003).
conclusionTwo-thirds of patients with ACLD suffer from anaemia. The degree of hepatic dysfunction and of portal hypertension correlate with severity of anaemia. Anaemia is associated with decompensation, ACLF and increased mortality in patients with ACLD.
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